Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2003 May;74(5):574–576. doi: 10.1136/jnnp.74.5.574

Efficacy of methylprednisolone pulse therapy on neuroleptic malignant syndrome in Parkinson's disease

Y Sato 1, T Asoh 1, N Metoki 1, K Satoh 1
PMCID: PMC1738449  PMID: 12700295

Abstract

Background: Neuroleptic malignant syndrome (NMS) is a dangerous complication in patients with Parkinson's disease (PD).

Aims: To evaluate the efficacy of methylprednisolone pulse therapy compared to placebo in PD patients with NMS.

Methods: In a double blind, placebo controlled study, 20 PD patients with NMS received steroid pulse therapy for three days, and 20 PD patients received placebo. Both groups received levodopa, bromocriptine, and dantrolene.

Results: NMS in the steroid group healed within 10 days in 17 patients; median value of duration of illness of NMS in this group was 7 days (range 4–20). NMS in the placebo group healed within 10 days in five patients; in the remaining 15, it persisted for 12–27 days after the onset of NMS; median value of duration illness of NMS in this group was 18 days. Hyperthermia, rigidity, and consciousness improved within 10 days in many patients in the steroid group; these signs persisted more than 10 days in many patients in the placebo group.

Conclusions: Steroid pulse therapy is useful in NMS for reducing the illness duration and improving symptoms.

Full Text

The Full Text of this article is available as a PDF (78.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Czyrak A., Chocyk A. Search for the presence of glucocorticoid receptors in dopaminergic neurons of rat ventral tegmental area and substantia nigra. Pol J Pharmacol. 2001 Nov-Dec;53(6):681–684. [PubMed] [Google Scholar]
  2. Gibb W. R., Griffith D. N. Levodopa withdrawal syndrome identical to neuroleptic malignant syndrome. Postgrad Med J. 1986 Jan;62(723):59–60. doi: 10.1136/pgmj.62.723.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Henderson V. W., Wooten G. F. Neuroleptic malignant syndrome: a pathogenetic role for dopamine receptor blockade? Neurology. 1981 Feb;31(2):132–137. doi: 10.1212/wnl.31.2.132. [DOI] [PubMed] [Google Scholar]
  4. Nisijima K., Noguti M., Ishiguro T. Intravenous injection of levodopa is more effective than dantrolene as therapy for neuroleptic malignant syndrome. Biol Psychiatry. 1997 Apr 15;41(8):913–914. doi: 10.1016/S0006-3223(96)00519-7. [DOI] [PubMed] [Google Scholar]
  5. Piazza P. V., Rougé-Pont F., Deroche V., Maccari S., Simon H., Le Moal M. Glucocorticoids have state-dependent stimulant effects on the mesencephalic dopaminergic transmission. Proc Natl Acad Sci U S A. 1996 Aug 6;93(16):8716–8720. doi: 10.1073/pnas.93.16.8716. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Rosenberg M. R., Green M. Neuroleptic malignant syndrome. Review of response to therapy. Arch Intern Med. 1989 Sep;149(9):1927–1931. doi: 10.1001/archinte.149.9.1927. [DOI] [PubMed] [Google Scholar]
  7. Tsujimoto S., Maeda K., Sugiyama T., Yokochi A., Chikusa H., Maruyama K. Efficacy of prolonged large-dose dantrolene for severe neuroleptic malignant syndrome. Anesth Analg. 1998 May;86(5):1143–1144. doi: 10.1097/00000539-199805000-00046. [DOI] [PubMed] [Google Scholar]
  8. Tsutsumi Y., Yamamoto K., Matsuura S., Hata S., Sakai M., Shirakura K. The treatment of neuroleptic malignant syndrome using dantrolene sodium. Psychiatry Clin Neurosci. 1998 Aug;52(4):433–438. doi: 10.1046/j.1440-1819.1998.00416.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES